Analysis of Indicators for Hospitalization for Extracorporeal Shock Wave Lithotripsy

Abstract

We used computer analysis to study events and factors before and after extracorporeal shock wave lithotripsy (ESWL) in 1002 treatments that would be indicators for hospitalization. Patients with calculi > 1 cm in total diameter were three times as likely to be hospitalized longer than 3 days and to have fever. Patients with ureteral calculi were most likely to be hospitalized and had higher incidences of obstruction and fever than those with calculi at other sites. Older patients were more likely to have prolonged hospitalization, obstruction, and sepsis and less likely to require more than one injection of analgesic. Major system disease and pre-ESWL urinary infection were independently associated with prolonged hospitalization, obstruction, and sepsis. Indications for additional procedures such as percutaneous nephrolithotomy also correlated with hospitalization. The predictability of outpatient ESWL continues to have limitation, however, and patient safety is the ultimate factor.